Lung-protective ventilation strategy

Mechanical ventilation in critical ill patients can result in the superimposion of iatrogenic lung injury and a worsening of morbidity and mortality. Underlying pathophysiological mechanisms are high inspiratory pressures (barotrauma), high tidal volumes(volutrauma), shear stress (atelectrauma) and local or generalized inflammation (biotrauma). Protective-ventilation strategies such as low-tidal volume ventilation, the application of an optimized PEEP, early recruitment manoeuvres, prone positioning and spontaneous breathing all aim to minimize mechanical and biochemical stress on the lung, and avoid alveolar injury.